[Repeated plasty of the esophagus in children with the application of transplant from the ileum].

The authors give topographic-anatomical substantiation of a possibility to employ the ileum for esophageal replacement and describe a technique of forming such transplant. Their clinical experience includes 9 operated children. Earlier they had endured from 1 to 4 attempts of esophageal replacements by different traditional methods. In all children operated upon good results were obtained. It allows the ileum to be included in the arsenal of possible methods of esophageal replacement and considering it as an alternate variant in nonstandard situations.

[Organ-preserving interventions in combined therapy of children and adolescents with osteosarcoma].

An analyzed cohort consists of 50 pediatric patients with osteosarcoma receiving combined therapy in N. N. Petrov Research Institute for Oncology (1999-2010). Thirty nine of them had localized disease, 11 patients had distant metastases. The treatment scheme included neoadjuvant therapy with cisplatin and doxorubicin, surgical treatment and adjuvant therapy depended on initial response and could include cisplatin, doxorubicin, high-dose methotrexate, ifosfamide, etoposide. Four-year overall and relapse-free survival in children with localized disease was 74.3% and 69.2% accordingly. In 62% of patients were performed organ-preserving surgical interventions, in 22 patients was performed endoprosthetics, in 4 patients the defect was replaced by a bone autograft on a vascular bundle. The effectiveness of initial treatment and secondary endoprosthetics were analyzed. Six patients with lung metastases received normotermic lung chemoperfusion, 4 of them are alive and disease-free for 8 to 24 months.

[Current problems of vascular surgery in childhood]. / Aktual'nye voprosy angiokhirurgii detskogo vozrasta.

Under analysis are remote results of treatment of 751 children with congenital and acquired diseases of the vessels. Grounds are given for treatment of these diseases in the light of the classical syndromes of disturbed hemodynamics. The investigation of developmental and individual peculiarities of these syndromes is thought to be necessary. The leading role of microsurgical methods of treatment of such diseases of the vessels in children is stressed.

[Current problems in the reconstructive surgery of the locomotor apparatus in children]. / Aktual'nye voprosy rekonstruktivnoi khirurgii oporno-dvigatel'nogo apparata u detei.

The authors analyze results of treatment of 778 children with malignant and benign tumors of the bones, pseudoarthroses, amputations of lower extremities and fingers, injuries of the tendons, vessels and contused-lacerated wounds of distal phalanges of fingers. The possibility to use a precision technique for the reconstructive operations of the vessels in children is shown.

[Surgical treatment of extrahepatic portal hypertension in children]. / Khirurgicheskoe lechenie vnepechenochnoi portalnoi gipertenzii u detei.

In the period from 1985 to 1992 sixty-three patients aged from 7 months to 15 years were treated for the portal hypertension syndrome, 60 had the extrahepatie form. Forty-five various operations for portosystemic shunting were carried out: formation of proximal splenorenal anastomosis in 31, distal splenorenal anastomosis in 4, mesentericocaval anastomosis in 6, gastrocaval anastomisis in 2, and an atypical vascular shunt in 2 cases. Nonshunting operations were performed on 8 patients. Since 1986 39 sessions of endoscopic sclerotherapy were conducted, 16 of them were carried out in cases with esophagogastric bleeding.

[Endoscopic sclerotherapy in the combined treatment of portal hypertension in children]. / Endoskopicheskaia skleroterapiia v kompleksnom lechenii portal'noi gipertenzii u detei.

The authors have performed 28 sessions of endoscopic sclerotherapy of dilated esophagus veins in children. The 70% ethyl alcohol was used. Six sessions were carried out in patients with gastroesophageal hemorrhage. In 22 patients the sclerotherapy was carried on according to plan. The fiber gastroscope with a standard injector was used. A conclusion is made of expediency of using endoscopic sclerotherapy in complex treatment of portal hypertension in children.

[Autologous transfusion of UV-irradiated blood in the complex treatment of children with dysplasia of deep veins of the extremities]. / Autotransfuziia obluchennoi ul'travioletom krovi v kompleksnom lechenii detei s displaziei glubokikh ven konechnostei.

Under examination there were 12 patients aged from 5 till 14 years. An investigation of hemostatic potential of blood in the diseased extremity and peripheral blood was performed. A mosaic character of blood coagulative alterations in this category of patients was detected. Autotransfusion of UV-irradiated blood is a pathogenetically grounded and accessible method of correction of hemocoagulation and may be included in the complex treatment of patients with dysplasia of the profound veins of lower extremities.

[Vascular microsurgery during esophagoplasty in children]. / Mikrososudistaia khirurgiia pri ézofagoplastike u detei.

Clinico-experimental data on using the microvascular technique in plastic operations on the esophagus are described. Experiments in puppies have revealed specific features of the surgical technique, the morphology of intestinal grafts and their taking under conditions of growing organism. The microvascular technique was used in 3 patients. In 2 patients additional nutrition of the grafts was performed, in 1 patient free transplantation of small intestine grafts to the cervical and thoracic parts of the esophagus was fulfilled. Results were good.